Plastic Bodies: Sex Hormones and Menstrual Suppression in Brazil by Emilia Sanabria (Duke University Press, 2016).
Emilia Sanabria’s Plastic Bodies is a captivating book and a much needed study on perceptions on menstruation and associated biomedical practices. In particular, it provides a different approach from the traditional Anglo or Anglo-American context because of the different ways in which women conceptualise their corporeality and bodily processes, as will be pointed out. The author addresses the lacuna in ethnographical studies about hormonal menstrual suppression by giving an ethnographic account of sex hormone use in Bahia through a focus on ‘how hormones are enrolled to create, mold, or discipline social relations and subjectivities’ (2016: 5).
Plastic Bodies is a pleasure to read; it is beautifully written and has a style that at times merges with the genre of travel writing enabling readers to accompany Sanabria to Salvador de Bahia where she conducted her fieldwork. This characteristic facilitates a close relationship between readers, the author and her interviewees which allows us to engage with such thought-provoking material and to understand the myriad perspectives that are at play when considering menstrual suppression for both menstruators and medical practitioners.
Sanabria’s central theme is the negotiation of bodily boundaries and therefore she finds the notion of plasticity, which she takes from Catherine Malabou (2004), to be useful as it considers bodies through continuous processes of self-transformation. Despite the fact that the author draws on seminal works on menstruation, such as those of Mary Douglas, who focuses on the relationship between bodily and social boundaries, and Emily Martin, whose work is based on the notion of considering menstruation as a failed conception, her fieldwork problematise these canonical works, as well as the rigid and binary considerations of sex hormones in biomedical science. The Brazilian context and her findings — that is, that bodily boundaries cannot be known a priori (2016: 56) — lead her to follow a post-structuralist approach much closer to Judith Butler’s notions of sex as a social construct. Sanabria is aware of the usefulness of Butler’s performativity although she could have explored this concept in more depth. Moreover, the author could have engaged with Butler’s (2004: 209) discussion around the idea of ‘original’ and ‘copy,’ which would have been very illustrative in Sanabria’s analysis of perceptions of ‘nature’ and ‘culture’ in Brazilian society.
Chapter One explores the multiple and ambiguous perceptions of menstruation that she encountered in her interviews and frames this ambiguity within the wider context of the body. Her analysis offers a fresh approach to the subject matter because her data disrupts the above-mentioned canonical works. The Brazilian context brings complexity to the discussion because in Brazil the body is not only perceived as malleable and plastic but is also very present in everyday conversations (e.g. people talk with ease about their bodies and share their expertise on health matters and tips for illnesses). In addition, medicine is an important institution that shapes the identities of urban Brazilians: the population is used to surgical interventions because the body is considered a ‘site of intervention’ through which to achieve a higher status in society (2016: 36). In Chapter Two, the author offers a clear understanding of women’s rationales for deciding to suppress their periods with hormonal methods. Chapter Three builds on Sanabria’s successful explanation in Chapter Two of the widespread acceptability and use of menstrual suppressive hormonal methods. The author here gives a detailed account not only of the different conceptualisations of blood and hormones but also of the ways in which the body is perceived in Brazilian society and its relationship with gender, class and race. All of which is influenced by neoliberal practices and the commodification of contraceptives in Brazil; aspects developed in Chapter Four in which the author focuses on inequality in access to biotechnological developments and medical services based on socioeconomical grounds. Chapter Five analyses the relationship between the symbolic and the material, that is, the ways in which the use of hormones shapes identities and influences social dynamics.
Plastic Bodies is a constant dialogue between the micro (i.e. the lived experience of the women interviewed) and the macro — understood in terms of discourses around national identity, and the meaning of modernity in the Brazilian context and the way progress shapes people’s conceptualisations about nature as violent and in need of being controlled. Within this context, Sanabria gives a fascinating account of the factors that contribute to considering menstruation as a hindrance which has to be regulated. The author’s comprehensive approach is everything but simplistic as she foregrounds the ambiguous perceptions about menstruation within the population (e.g. periods are considered unhygienic and cleansing at the same time). In order to explore this complexity, the author highlights the current rhetoric in urban Brazil according to which menstruation is regarded as an ‘artefact of modern life’ (2016: 76). This consideration comes from the fact that women have periods more often than in the past because of bio-cultural factors such as changes in lifestyle and diet. This fact and a ‘fetishism of the primitive’ (2016: 101) create a breeding ground for menstrual regulation and suppression in order for women to manage the demands of work and motherhood. Sanabria’s enlightening analysis pays close attention to multiple factors that justify the use of hormonal suppression. She concludes that this rhetoric suits both machista and neofeminist currents because women are granted the freedom to choose when to menstruate or to stop having periods. I would add here the neoliberal context and the influence of the pharmaceutical industry and the private and public health sector which promotes medicalisation and normalises medical procedures with different goals depending on class (e.g. technologies of self-enhancement versus family planning policies).
Sanabria’s analysis in Plastic Bodies pushes disciplinary boundaries and is very relevant within the context of medical humanities because she emphasises that the effects of hormones have to be considered in a broad sense and not be limited to their pharmacological action. She gives a clear account of the ways in which hormonal effects also depend on gender, class and global dynamics that include the creation of ‘new’ drugs by the pharmaceutical industry, and concerns with overpopulation.
Reviewed by Ángela Lavilla Cañedo, a PhD candidate in the Section of Hispanic Studies at the University of Sheffield. Her research explores representations of menstruation in contemporary Hispanic women’s writing.
Correspondence to Ángela Lavilla Cañedo.
Butler, Judith. 2004. Undoing Gender. New York: Routledge
Malabou, Catherine. 2004. Que faire de notre cerveau?. Paris: Bayard